The Overweening Generalist is largely about people who like to read fat, weighty "difficult" books - or thin, profound ones - and how I/They/We stand in relation to the hyper-acceleration of digital social-media-tized culture. It is not a neo-Luddite attack on digital media; it is an attempt to negotiate with it, and to subtly make claims for the role of generalist intellectual types in the scheme of things.

Overweening Generalist

Saturday, December 31, 2011

The Drug Report: December 2011

O! The drugs! The scads of pills and their legalities and usage and subjective effects! Their uses as muses, their predictable abuses! Billowing smoke rings of pungent funky dream-matter. That swallowed product of High Technology that will be sure to relieve you of your general feeling-badness and return you to some semblance of mommy's amniotic warm din. Or just get you through. The smokey haze of powders and deranged senses and intoxicating scents! The madnesses and sadnesses and euphoria-bliss-gladnesses! Let us discuss a few.

Recent Dumb Clamor Over New and Improved Vicodin
You may have heard that more than one Big Pharma Co has come up with a 2.0 version of the painkiller Vicodin - the most prescribed drug in the world - that is safer, and yet, according to one article, ten times stronger than Vicodin. The version I've heard most about is called Zohydro. (Vicodin, or "vikes" to the street pillheads who love 'em for recreational purposes, is hydrocodone.) So why do I assert the dumb clamor? Because this new version has - finally! - done away with acetaminophen.

Acetaminophen - Tylenol - which is also thrown into hundreds of other OTC preparations, does too much liver damage. Early in 2011 the FDA moved to lower the amount of acetaminophen in a "dose" to 325mg. The ceiling for a day is supposedly 4grams, or 4000mg. Many doctors have seen liver failure at 2.5grams in a day. That's a lot of acetaminophen in a day. But think of it: at one 325mg dose, if you're in a lot of pain and take 8 pills in a 24 hour period, you're over the 2.5 that doctors have seen cause liver failure. Liver failure is something to be avoided, kiddies. It's not a pretty sight. (Acute liver failure)

A hidden problem with acetaminophen is that sometimes people are taking it in other medications, but don't know it. That's adding to the day's toll on the liver. The FDA advised the lower dose at 325 only for prescription meds, not stuff you can just waltz into the drug emporium and buy on a lark. Why is acetaminophen so prevalent if it's risky, even "relatively dangerous"? Because it's easy to make; it's really cheap. And in low doses, it works pretty well. There are people making pretty decent coin as "Tylenol Lawyers" though, so that ought to give you pause.

Why not grab the alternatives ibuprofen or naproxen? They're linked to intestinal bleeding, but probably, on the whole, a lot safer than acetaminophen.

If you see "APAP" or "ACET" on your medications, you're getting some acetaminophen thrown it. Beware...

If you want to take acetaminophen, know the state of your liver. (Few of us do, right? Unless we recently had a blood panel done, we are saddled with some missing information here. Liver failure is quite often Game Over; this is serious stuff to mess with.) Also: the drug companies don't make a big to-do about it, but you really ought to have some food in your stomach for that acetaminophen to fall into. They don't want you to sweat worrying about eating, your liver be damned. And finally: NEVER drink alcohol with acetaminophen! It's not smart. (Please read the previous sentence, the one starting with "NEVER," again.)

More Deaths From Pharmaceutical Drugs Than Auto Accidents Now
In 2009 Unistat, the last year we have the data to yell and scream about, 37,485 people died from ODs of pharmaceutical drugs. That's doubled since 1999. In 2009, 36,284 people died in auto wrecks. It was close, but in 2009 someone's Rx beat out the highway fatalities. And then coming in a close third, 31,228 died of firearms in Unistat. Think about it: someone's doctor okayed the drugs that contributed to those deaths. (Patients are complicit, of course: STOP mixing strong drugs! STOP drinking with tranquilizers! Why do we have to say this? Because we inherently believe that the doctor, the community, the good people at OmniCorp...wouldn't steer you wrong? That they'd say they "really mean it" that you ought not, say drink a six-pack, then swallow three Tylenol, a Vicodin, a Soma, two Xanax, and then apply a Fentanyl patch and drive out to the desert? Did you know - of course you didn't - that when you take Soma it breaks down in your liver into Meprobramate, which potentiates the other drugs in your system? Oh? You DID know? You sicko!)

I couldn't find any data on people who were zonked out on painkillers or tranks while driving, and a loaded gun was found in the wreckage. But it would be interesting to know.

The people all up-in-arms about the non-acetaminophen Vicodin about to hit the streets (Zohydro), are worried about the potential for addiction. And they have a point. People will LOVE this stuff and get addicted. But at least it's doing its painkilling with good old fashioned opiates. What the stories you'll read and hear regarding Zohydro won't mention is how bad acetaminophen was, and even Big Pharma had to take notice! And they couldn't care less about the pharmaceutical addiction and accidental death epidemic in Unistat. They're in the overwhelmingly lucrative biz of selling pills.

It's difficult to find out just how bad the Problem is, and why. Psychiatrist Ronald Ricker says the drug war didn't work, then a few lines earlier you see he says the DEA needs to get tougher on these drugs: tranks, painkillers, amphetamines, and antidepressants. I'd be embarrassed to tell you all how long I've been paying very close attention to this larger story, of drug use in Unistat. But I will say that I think Dr. Thomas Szasz (say "Zaz") has the sanest approach to this problem. I do not think we will see a Szaszian approach to drugs in Unistat any time soon, though, for structural reasons: drugs are a fantastic guise for the Ruling Class to whittle away at civil rights, and keep the poor brown people in line. The cops/DEA/district attorney/lawyer/prison/"rehabilitation" complex is too lucrative. And let's not mention asset forfeiture!

(Why do Unistatians gobble 86% of the Adderal and Ritalin in the world? Consider this your zen-ish koan of the day.)

Those are structural reasons. To me, the deeper level is the authoritarian character structure in most Americans. It's built into their muscular rigidity. It's about fear and stupidity and just saying, "Not only do I NOT want to know about how drugs really work, about my own and others' human nervous systems, the biophysical basis for drug craving and addiction, the history of drug use, etc, I'd rather watch another morality play about drugs put on by the cops."

I will now climb down off my soapbox.

Oxytocin Dreams
Not OxyContin, which is hovering in the background of the two sections above, oxytocin is a hormone we humans make endogenously, and it's secreted into the bloodstream when nipples are stimulated. It's also linked to cuddling, mothering, empathy, social recognition, reduced fear, reduced anxiety and reduced racism, and many a polypeptide-savvy female has dreamed or spoken or written openly about curing social ills by making it a nasal spray and giving it to men. And frankly, I see where they're coming from.

If it sounds like MDMA/Ecstasy, it's likely that both activate the same serotonin receptors.

You'll see a few products for sale on the Net, like this nasal mist. Or this, which is not a product but "sells" the idea of it to females. But if you read the Wiki that linked to this study, you saw that oxytocin is destroyed in the gastrointestinal tract. So a pill is out. By injection, it doesn't get through the crucial blood-brain barrier. Strike two. And then this: "[...] no evidence for significant central nervous system entry of oxytocin by nasal spray. Oxytocin nasal sprays have been used to stimulate breastfeeding, but the efficacy of the approach is doubtful."

Still: neuropharmacologists are working on it.

Young girl hugging a kangaroo: oxytocin probably involved

In a study published in Psychopharmacology and reported in Science Daily earlier this month, a study at Concordia University - a hotbed of oxytocin studies - gave 100 males and females intranasal oxytocin, and they waited 90 minutes and then filled out a questionnaire which showed they beat the placebo and in general that their self-perception was more extroverted, social, open to new ideas and trusting.

But I must say, it sounds like a weak study. Let's see some ingenious relativized double-blind placebo-controlled studies. I suspect just being in a study like the one at Concordia will tend to make you feel more..."open." I'm not calling for a fog machine of thick vaporized oxytocin be blown in the face of passengers getting off trains in Grand Central Station, only to see them all stop, take off their clothes and "hug," I'm just sayin'...(What am I sayin'?) Another way of saying it: I suspect the mysterious placebo failed on this one...

A recent and fascinating wrinkle in the oxytocin literature was published around August of this year, in Current Directions in Psychological Science. In study subjects given oxytocin and who then played a game of chance with a fake opponent, feelings of anger, gloating, and envy occurred. Why? The researchers at first thought oxytocin had something to do with supporting social emotions, but later thought it was more specific: it deals with "approach-related emotions." These have to do with wanting something, not with shrinking away! Read the abstract from Science Daily here.

After reading a few more studies, I wonder how much higher the quality or dosage level the researchers get to deal with, rather than that stuff you buy from someone on the Net.

A Drug to Combat Kleptomania?
Quick now: what do nymphos, pyros, shopaholics, gamblers, kleptos, alkies and junkies have in common? If you said, "They're my friends," then you're right, but that's not what I was looking for. (Hey, I tend to gravitate to some of these people too, but I'm working on it...my own male nympho alcoholic klepto pyromania, that is. Yes, when I sober up and put my pants on, I make a bonfire of every dippy thing I stole. Ahem.)

No, what we're looking for here is: a problem with impulse control. Some alcoholics and heroin addicts have been treated with naltrexone, which binds to opiod receptors. Psychiatrist Jon Grant has some research that suggests the same drug could help that delightful crowd I named above too, because they all do what they do and feel bad about it; they can't help it. In the moment, it's really exciting. As Grant says, they know morally it's the wrong thing to do, and they really ought not, "yet they get a rush from it, and it's very enticing."

I'm interested in the disjuncture between the justice system and the medical profession. Readers of people like M. Foucault would cite the ever-increasing "medicalization" of our world, and they have strong points. Very strong points that should be heeded. But as Grant says, he doesn't think law people are ready to think of kleptomaniacs as having a psychiatric condition. They're "criminals."

This tells us soooo much about our society, doesn't it?

We have built very deeply into our social systems the idea that you have one unitary identity. It's capable of reason, has a name, numbers and by the age of 18 is responsible for what it does.

I'll elaborate much more in some future post, but I think this is probably wrong, and there are a lot of reasons to believe it's wrong. Our justice system requires this Old Enlightenment idea of the Self, so it can prosecute. But we know billions of facts about human neurobiology that they didn't in the 17th and 18th century Enlightenment. As my favorite neuroscientist, Robert Sapolsky, often says, it gets to the point where we understand the neurological underpinnings of what's going on with a person, what makes them "sick," and we really need to say that it's not the person. It's the person AND their disease.

Regarding kleptomania, the study I linked to says 11% of us shoplift at some point in our lives. I did between ages 14 and 15. I stole paperback books of collected Mad magazine bits, sports heroes (I recall things like Basketball Stars of 1975), and biographies of what seemed then like interesting people. I didn't get all that much joy from the books. (I got some. I mean, they were books, and I later morphed into an overweening generalist...)

It was thrilling to steal though. I remember a friend teaching me how. Then, about the 20th time or so, I got caught. I was underage, so the store detective scared the wits out of me and eventually let me go, telling me to never enter their store again. I haven't stolen a thing since. I've thought of it, but the idea of getting caught is so abhorrent I quickly forget it. Besides, I've been conditioning my brain to want less and less things. As a Unistatian, I'm a very poor consumer - and that's what Unistatians REALLY believe in. Not fairness, decency, peace, universal brotherhood or any of that stuff: gadgets. Trinkets. The latest electronic gadget. Commodity fetishism. Labels. Louis Vuitton bags. Salad shooters. And Prof. George Carlin liked to sneer in contempt with this example: sneakers with lights on them. As far as the act of just sheer buying worthless crap? I don't do it. I'm a Bad American.

Anyway, I forget what Jean Genet story (was it Querelle?) it was where he tells us he used to enjoy breaking and entering into people's homes, not because he wanted to steal anything as much as the visceral thrill of being in someone else's house! Absolutely illegally and possibly dangerous. Some stranger's place! What a thrill! And when Winona Ryder got caught, I understood. I was with Winona then, in spirit. I still am. Jeez, just look at her!

About Me

I have furore scribendi which veers into verborrhea. My favorite media (anything that mediates between our sensoria and what is outside our skin) are, in order: books, Internet, CDs (!), DVDs, TV, clothes. I like hoppy beer and New World zins, Indian and Thai food, John Coltrane, JS Bach and heavy metal, the Lakers and Angels, redwood trees, hiking and yoga, bright copper kettles and warm woolen mittens, heretical ideas and pornography. If you want me to write for you, for money, contact rmjon23[at]aol[dot] com. You can also drop a line and say hi, but please be nice 'cuz I'm a delicate creature of Nature.

Sir Isaiah Berlin

"An intellectual is a person who wants ideas to be as interesting as possible. Unless you think the ideas you are discussing are interesting to you, whatever you may believe yourself, the history of ideas will remain a catalogue of unexamined doctrines, terribly boring and unreal."

-Isaiah Berlin, in conversation with Ramin Jahanbegloo

Leonardo da Vinci

Epitome of Renaissance Man

Athanasius Kircher (c.1600-1680)

The last universal polymath? The last man to know everything? Egyptologist, archaeologist, mathematician, vulcanologist, physicist, biologist.